|» deductible||» doughnut (donut) hole|
|» disability benefit||» dual eligibles|
|The amount that the beneficiary must pay first, before coverage from the plan makes any of the payments. In Part D this is usually the first $435 of eligible drug expenses for the year.
|A feature of some policies for the waiver of premium if the policyholder becomes permanently and totally disabled.
|When you disenroll, you end your coverage in a prescription drug or other health plan. Your plan can choose to disenroll you under specific circumstances.
|doughnut (donut) hole|
|The gap in your coverage that spans between ordinary drug coverage and catastrophic drug coverage. In this gap, the Medicare beneficiary pays 100% of their prescription costs. According to the federal government, about 88% of Medicare beneficiaries who enrolled in a Medicare Part D plan do not have Donut Hole (or doughnut hole) coverage. The standard or model Part D coverage begins with a deductible of $435 followed by a co-pay of 25% on the next $3585 (you pay $896.25). Upon reaching the total medication costs of $4020 (with $1331.25 out of pocket), coverage ceases and the beneficiary is 100% responsible for all costs during a "blackout period" known as the "Donut Hole" or "Coverage Gap", until a new spending tier, an additional $5018.75 out of pocket, is reached and coverage kicks in again at the "Catastrophic" level. See Coverage Gap.
|People eligible for both Medicare and Medicaid.